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Head Neck tumors - When to think of malignancy

Benign head neck tumors are common, while malignant tumors are rare. The question is, when do we need to think of a malignant tumor, since many radiologists will not frequently be confronted with a malignant tumor. In this article we provide you with some red flags, that may help you to recognize the occasional malignant lesion in daily practice.

TI-RADS - Thyroid Imaging Reporting and Data System

Up to 67% of the population evaluated with US will have an incidental thyroid nodule.The high prevalence of thyroid nodules combined with the generally indolent growth of thyroid cancer present a challenge for optimal patient care.The Thyroid Imaging Reporting and Data System (TI-RADS) of the American College of Radiology (ACR) was designed in 2017 with...

US of the GI tract - Technique

The GI tract is the most challenging part of the abdomen to examine by US. Although technically demanding, its results have great clinical implications in early triage of bowel diseases and in the acute abdomen. This is the first of a series on US of the GI tract. Press ctrl+ for larger images and text on a PC or ⌘+ on a Mac.This can...

Arthroplasty of the Hip

Radiography is the primary imaging method for the evaluation of Total Hip Arthroplasty. This overview focusses on the normal findings and complications of cemented versus non-cemented hip arthroplasties. Interactive cases are presented in the menubar to test your knowledge on hipprostheses.

Acute Pancreatitis

The 2012 Revised Atlanta Classification of acute pancreatitis enables standardized reporting which is helpful for communication between clinicians and for research.A standardized template for reporting CT images is given to describe the local complications of acute pancreatitis.

Ultrasound of the Neonatal spine

Ultrasound is the preferred modality in neonates with suspected occult spinal dysraphism (OSD).OSD implies the presence of one or more spinal cord anomalies, which can cause tethering of the spinal cord and possible neurological and bladder or bowel function deficits. Ultrasound is easy to perform, since the posterior arch of the vertebra is not yet...

Transvaginal Ultrasound for Non-Gynaecological Conditions

This is an overview of the use of Transvaginal Ultrasound (TVUS) for the diagnosis of various non-gynaecological conditions as they appear in the pelvic cavity.This pictorial essay is for gynaecologists who want to look beyond pathology of uterus and ovaries, and diagnose non-gynaecological conditions. Also included here is Deep Infiltrating Endometriosis...

Appendicitis - Pitfalls in US and CT diagnosis

In this chapter we will deal with the optimal diagnostic strategy in patients with suspected appendicitis, and the pitfalls leading to a false-positive or false-negative diagnosis. Special attention will be given to: Abnormal location of the appendixDifferential diagnosis of appendicitisComplications. For critical comments and additional...

Crohn's disease - role of Ultrasound

In this section we will discuss the sonographic features used to evaluate Crohn’s disease. After reading this section, you will be able to:Recognize normal bowel wall appearance and morphological changes of the bowel wall in Crohn’s disease, using ultrasound.Identify the classic US  features of Crohn’s disease. Sonographically...

Renal Tumors in Children

Wilms tumor comprises the vast majority of renal neoplasms in young children and resection with neoadjuvant chemotherapy is the treatment of choice.Most other renal tumors cannot be reliably distinguished from Wilms tumor at imaging, but some features may suggest an alternative diagnosis, which in some cases can lead to the decision to adjust the...

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Cystic Lung Cancer

Cystic primary lung cancer is increasingly being recognized as a unique imaging morphology.In this article we will discuss the imaging features and managementPress ctrl+ for larger images and text on a PC or ⌘+ on a Mac.Most images can be enlarged separately by clicking on them.

Sharp foreign bodies in GI tract

This is an overview of the widely variable US and CT  presentation of sharp foreign bodies perforating the wall of stomach or bowel. This pictorial essay is based on a literature search and our personal experience with 49 cases and will enable you to make the correct diagnosis, to understand the natural course and also to help the clinician to choose...

Anatomy and Pathology of the Infrahyoid Neck

In this article we will focus on:a 3-step approach on how to analyze pathology of the infrahyoid neck on cross-sectional imaging..the 5 anatomical spaces of the infrahyoid neck.

Solid Abdominal Masses in Children

Malignant abdominal tumors in children are rare and usually present as solid masses. Treatment is done in specialized centers, but the initial diagnosis is usually made in the hospital where the child first presents.In this article we will provide tools to make the initial imaging diagnosis of the most common malignant abdominal tumors as accurate as...

Staging and Treatment of Breast Cancer

Imaging plays a major role in the detection and staging of breast cancer and monitoring treatment.In this era of rapidly changing management of breast cancer, it is important to be familiar with the staging classification and be aware of the available surgical, radiotherapeutic and oncological management options in order to provide relevant information...

Biliary duct pathology

This review is based on a presentation given by Angela Levy and adapted for the Radiology Assistant by Robin Smithuis. We will discuss: Nonobstructive biliary disorders Obstructive biliary neoplasmsby Angela D. Levy

Non-traumatic Intracranial Hemorrhage

Any type of bleeding inside the skull or brain is a medical emergency.The most common causes of hemorrhage are trauma, haemorrhagic stroke and subarachnoid haemorrhage due to a ruptured aneurysm.Complications are increased intracerebral pressure as a result of the hemorrhage itself, surrounding edema or hydrocephalus due to obstruction of CSF.In this...

Practical approach to Acute Abdomen

The 'acute abdomen' is a clinical condition characterized by severe abdominal pain, requiring the clinician to make an urgent therapeutic decision. This may be challenging, because the differential diagnosis of an acute abdomen includes a wide spectrum of disorders, ranging from life-threatening diseases to benign self-limiting conditions (Table...

Cystic Abdominal Masses in Children

Cystic masses in the abdomen of a child are common. Many of these are discovered with prenatal ultrasound. Others are detected when a child has abdominal complaints and imaging is performed. The cyst is either the cause of the complaints or an incidental finding. In this pictorial essay we will show the most common abdominal cystic masses in...

Pulmonary Fibrosis

In this article we will discuss lung diseases with a reticular pattern and provide a guidance for radiologists to evaluate the most common diseases and their patterns. A stepwise approach is presented to identify the key features in fibrotic lung disease and to make it easier to reach a differential diagnosis.Images can be enlarged by clicking on...

Epilepsy - Role of MRI

In many patients with epilepsy antiepileptic drug treatment is unable to control the seizures. Using a dedicated MRI-protocol, it is possible to detect an epileptogenic lesion in 80 percent of these patients. Resection of these lesions can lead to seizure freedom in many patients. We will discuss the MRI protocol and the typical findings in the most...

Ultrasound in Acute Abdomen

Multi-slice CT is increasingly replacing ultrasonography for the evaluation of patients with acute abdominal pain.Ultrasound however has specific advantages. This review will focus on:The advantages of US compared to CTUS techniqueThe use of US in patients with Acute abdomenPittfalls in the diagnosis of AppendicitisFor critical comments and additional...

MRI traumatic changes

This article is based on a presentation given by Mini Pathria and was adapted for the Radiology Assistant by Jennifer Bradshaw. In part I we will discuss MR features of various muscle injuries. In part II we will discuss non-traumatic muscle changes.